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Male Pelvic Viscera

     The third lecture in our series focuses on the male pelvic structures, the visceral organs of the urogenital system and their relationships.  Again, because of the condensed nature of this region various structures are difficult to observe.  Typically students rarely see the prostate and its associated structures clearly.  The relationships of these structures to important neurovascular structures are even less clear. Students are taught the significance of prostatic relationships because of the high incidence of benign prostatic hypertrophy and prostatic cancer. But visualization of the prostatic plexus is almost impossible.

    We have begun to extract male pelvic viscera from the Visible Human and have found these images to be extremely informative.  The true color rendering of the surfaces of the bladder, urethra and prostate is remarkable and unlike the bony pelvis contribute a great deal to an understanding of the anatomy [Figure 11]. Most atlas and textbook illustrations of this region are misleading. The bladder is usually shown on top of the prostate.   While we recognize that this is a sample size of only one, these relationships appear very different in the visualization of the bladder and prostate obtained from the Visible  Human.

    We hope to combine these images of the pelvic viscera with those of the bones and muscles to show the relationship of the pelvic and urogenital diaphragms to these structures.  We can generate transparencies of the individual components of the different systems [Figure 12] to better illustrate relationships as we have done with the prostatic urethra and ejaculatory ducts. Structures nearly impossible to see in cadaveric dissections.

    Ultimately we can combine these images to allow interactive tutorials that illustrate the various approaches to the prostate for prostatic surgery and allow students to view important structures that are compromised by the approaches to the prostate.

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